微创经皮骨穿刺注射自体红骨髓组织工程复合物治疗骨囊肿的临床应用研究  

The Clinical Study on Bone Cysts Treated Percutaneous Injecting Tissue-Engineering Complex of Autologous Red Bone Marrow

作　　者：杨新明[1] 石蔚[1] 曾春萍 邹宇纬[1] 孟宪勇[1] 平立涛 李金 苏立军 杨峰 

机构地区：[1]河北北方学院附属第一医院,河北张家口075000 [2]张家口药检所,河北张家口075000 [3]正大福瑞达集团石家庄办事处,河北石家庄050000 [4]张家口沽源县医院,河北沽源075000 [5]张家口尚义县医院,河北尚义075000 [6]内蒙古正蓝旗医院,内蒙古正蓝旗027200

出　　处：《河北北方学院学报（医学版）》2005年第6期1-4,共4页Journal of Hebei North University:Medical Edition

基　　金：河北省科学技术研究与发展指导计划项目(编号:052761585)

摘　　要：目的:探讨微创经皮骨穿刺注射自体红骨髓组织工程复合物治疗骨囊肿的临床疗效.方法:2004.1～2005.2月,对18例骨囊肿患者(男12例,女6例,平均年龄13岁;其中肱骨近端9例,股骨近端4例, 胫骨近端1例、远端1例,尺骨近端1、远端1例,桡骨远端1例)以玻璃酸钠为载体抽取自体红骨髓加入甲基强的松龙,在X线透视下,将2根骨穿针经皮分别自囊腔顶部和底部刺入骨囊肿内,抽去囊液,冲洗囊腔后注入复合物.其中14例注射1次,4例注射2次间隔2～3个月.结果:本组病例随访时间10～18月,平均14个月,骨愈合良好,无复发及并发症.根据Neer和Chrigira的X线评价骨囊肿愈合标准进行评估,本组18例治疗10个月后均达到Ⅳ级,骨囊腔完全愈合,愈合时间3～10个月,平均5个月,治愈率100%.结论:本方法治疗骨囊肿疗效确切、方法简单、不需手术、创伤小、痛苦轻、无并发症、费用较低、患儿及家长易于接受,是一种安全有效、治愈率高、便于基层医院推广使用的新型治疗方法.Objective,To investigate the clinical effectiveness of tissue engineering complexation of autologous red bone marrow and methylprednisolone with sodium hyaluronate injected percutaneously in the treatment of bone cysts. Methods.. The treatment of 18 cases with bone cysts was reviewed, which there were treated from January 2004 to February 2005. There werel2 males and 6 females with an average age of 13 years-old. The bone cysts were located in the proximal humerus（n=9）, proximal femur（n= 4）, proximal tibia （n= 1）, distal tibia（n= 1）, proximal ulna（n： 1）, distal ulna（n= 1） ,and distal radius（n= 1 ）. Under fluoroscopy, two fine bone marrow biopsy needls pierced the bone cysts from the top and the bottom of the cyst respectively. The intracystic fluid was drawn out, the cyst cavity was irrigated and then the tissue engineering cornpb exation of autologous red bone marrow and methylprednisolone with sodium hyaluronate was injected in pereutaneously. Among the 18cases, 14 received 1 injection, 4 received 2 injections in 2 - 3 months interval. Results： The patients were followed-up for 14 average months（10-18 months）. All 18 cysts were cured satisfactorily and no complication or recurrence occurred during the treatment. According to Neer and the Chrigira classification standards on the new bone formation, all 18 cases were classified as grade Ⅳ. The time for bone cysts cavity to grew together again in 18 eases was 3 - 10 months （mean time 5 months）. Conclusion： This method for the treatment of bone cysts has the following advantages ：less pain, easy manipulation, low cost, no surgery, little invision, no complieation and definite effect.

关 键 词：骨囊肿 微创 自体红骨髓 移植 类固醇 甲基强的松龙 玻璃酸钠 组织工程 

分 类 号：R681[医药卫生—骨科学]